1. And pregnancy complications
Labor and Delivery
And pregnancy complications

2. Labor - Initiation
Contractions
Ruptured amniotic sac (“water breaks”)

3. Stages of Labor – Stage 1 Early Labor Active Labor Transition Labor
~ 8 hours
Active Labor
~ 4-8 hours
Transition Labor
~ ½ hour - 2 hours
Cervix Dilation
0-3 centimeters
4-8 centimeters
8-10 centimeters
Contraction Frequency
5-20 minutes apart
3-5 minutes apart
2-3 minutes apart
Contraction Intensity & Length
- Mild/irregular - Lasting about seconds
- More pronounced - Lasting about 60 seconds
- Intense
- Lasting about seconds

4. Stages of Labor – Stage 1

5. Labor – Stage 2 Length: From one contraction up to 2 hours
A: Resting Phase
B: Descent Phase: Contractions (3-5 minutes apart, 60 seconds long) accompanied by strong urge to bear down
C: Crowning Phase: Baby’s head descends to opening of vagina – does not recede with contractions

6. Labor – Stage 3 10-20 minutes after baby is born
Placenta, amniotic sac, umbilical cord are delivered. Lasts few minutes

7. Pregnancy Complications

8. Tubular Pregnancy/ Ectopic Pregnancy
Implantation of fertilized egg in any location other than the womb.
Fallopian tube most common (98%)
Remedy or solution for tubal pregnancy
Surgery
Loss of fallopian tube
Chances of getting pregnant cut in half

9. Caesarian Section (C-section)
Doctor removes the fetus surgically
Reasons:
Breach, not positioned correctly
Fail to descend
Mother’s pelvic structure
Baby too big
Active herpes
Multiple births
Mother or baby under stress
Monitor heart beat
Toxemia
High blood pressure
Kidney damage

10. Toxemia Unknown cause Common in teen pregnancies
Swelling of face, ankles, HBP, convulsions if severe
Meds, checkups, early delivery

11. Gestational Diabetes Mother’s blood brings extra glucose to the fetus
Fetus makes more insulin to handle extra glucose
Extra glucose gets stored as fat and fetus becomes larger than normal
Glucose monitoring kit given to pregnant women with gestational diabetes

12. Rh incompatibility
Mother’s immune system reacts against the fetus’s blood
Causes anemia, fetal death
Shots before and after pregnancy, monitor
Mother Rh- and father Rh+

13. Still Birth Fully developed fetus is born dead Causes:
Placenta separates too early, smoking, alcohol, drugs
Umbilical cord can stop blood from getting to brain

14. Miscarriage
Any pregnancy that ends spontaneously before the fetus can survive outside the womb (gestational age: 20 to 22 weeks or less)
Occurs in 15-20% of all recognized pregnancies, usually before the 13th week of pregnancy.
Causes: Varied, and can’t always be determined. Chromosomal abnormalities, vascular disease, diabetes.
Alcohol or drug use and smoking are risk factors.
Exercise, working, and sexual intercourse do not increase risk in uncomplicated pregnancies

15. Premature/ Preterm Birth
Less than 37 weeks gestational age
Greater risk for short and long term complications, including:
disabilities and impediments in growth and mental development.
Causes: Elusive and unknown
Progress made in care of premature infants, but not in reducing the prevalence of preterm births.

16. Common Birth Defects
Birth defects affect one of every 33 babies in the world
Can affect almost any part of the body
Heart defects
Most common
1 in every 150 babies is born with a heart defect
Accounts for 1/3 to ¼ of all defects
Lip and roof of the mouth
Orofacial clefts
Cleft more common than palate
Affects about 1 in 700 to 1,000
6 months old
1 month after surgery
5 years old

17. Down Syndrome Genetic condition
Affects more babies that are born to older mothers
1 in 800

18. Neural Tube Defects
Spina bifida: Incomplete development of spinal cord or its coverings
1 in 1,000
Very serious and life threatening
Can be closed with surgery in utero
Results in disabilities
Preventive measure: folic acid prior to conception

19. Fetal Alcohol Syndrome
… And Drug-Affected Disorders
Next Lesson!